Kariesprophylaxe als multifaktorielle Präventionsstrategie

by Zimmer, Stefan

Abstract (Summary)

In these days, politics is aimed at enhancing dental prophylaxis by supporting non professional oral hygiene measures. In addition, special programs are promoted which focus on caries prevention in high risk groups as part of dental group prophylaxis. In two studies, therefore, the effectiveness of different programs for caries risk-children was examined. In three other studies, the effectiveness of newly developed manual and electrical toothbrushes was tested. ·Caries risk studies a)An individualized program with professional toothcleaning and the application of a low dose fluoride varnish (0.1% fluoride) was performed four times a year. After two years of implementation this program did not show a caries preventive effect when compared to a control group. b)In primary school children a high dose fluoride varnish (2.26% fluoride) was applicated two times a year over a period of four years. This was done in the school within the group prophylaxis. This measure resulted in a 37% caries reduction (p<0.05) when compared to a control group. ·Toothbrush-studies c)In this clinical study, the three headed manual toothbrush Superbrush was superior in preventing gingivitis and in removing plaque (p<0.001) when compared to a conventional manual toothbrush (Elmex) and the electrical Braun Plak Control. No difference could be seen between Braun Plak Control and the manual toothbrush. In the final examination medians of the indices were found to be 0.84 (Superbrush) vs. 1.56 (Braun) and 1.56 (Elmex) for the QHI, 0.69 (Superbrush) vs. 0.87 (Braun) and 0.94 (Elmex) for the API and 0.36 (Superbrush) vs. 0.55 (Braun) and 0.57 (Elmex) for the PBI. d)In this clinical study, two sonically activated power toothbrushes (Water Pik Sonic Speed and Sonicare) were compared to a conventional manual toothbrush (Elmex) considering the efficacy in plaque removal and gingivitis prevention. For both the sonic toothbrushes were superior to the manual toothbrush (p<0.001). The medians of changes of the oral hygiene indices were as follows (negative value = deterioration): QHI: 1.48 (Sonic Speed); 1.27 (Sonicare); 0.35 (Elmex); API: 0.39 (Sonic Speed); 0.45 (Sonicare); 0.14 (Elmex); PBI: 0.31 (Sonic Speed); 0.49 (Sonicare); 0.13 (Elmex). e)In this clinical study, four power toothbrushes (Krups Biocare Program, Krups Biocare Family, Krups Biocare Jetpack, and Braun Plak Control Ultra D9) were compared with a manual toothbrush (Elmex) regarding the effectiveness in plaque removal and gingivitis prevention. The Biocare Program was superior to all other systems when regarding the gingiva index PBI (p<0.01). For the plaque index QHI, a difference could only be seen between Biocare Program (p<0.001) and Braun Plak Control (p<0.05), respectively and the manual toothbrush. For the approximal plaque index API, no difference could be seen among the groups. The medians of change of indices were as follows (negative value means deterioration): QHI: 0.02 (Family); 0.25 (Family); 0.07 (Jetpack); 0.05 (Braun) and -0.18 (Elmex); API: 0.00 (Family); 0.00 (Program); -0.08 (Jetpack); -0.07 (Braun) and -0.04 (Elmex); PBI: 0.00 (Family); 0.09 (Program); 0.00 (Jetpack); -0.04 (Braun) and -0.17 (Elmex).